Original articleAdult cardiacIs an Age of 80 Years or Greater an Important Predictor of Short-Term Outcomes of Isolated Aortic Valve Replacement in Veterans?
Section snippets
Patient Population
The Veterans Affairs (VA) Continuous Improvement in Cardiac Surgery Program (CICSP) is part of the VA Surgical Quality Improvement Program and prospectively collects risk and outcomes data on all patients who undergo cardiac surgery at any of 44 VA cardiac surgery centers [17, 18, 19]. After obtaining Institutional Review Board approval and waiver of informed consent, we requested and received approval for the study from the Department of Veterans Affairs Surgical Quality Use Data Group. We
Entire Cohort: Risk Profile
Of all the patients who underwent isolated AVR during the study period, 7% (504 of 7,142) were 80 or greater years old. The vast majority of patients in both age groups were male (Table 1). Compared with the younger patients, the older patients had a higher prevalence of peripheral vascular disease (20% vs 14%), cerebrovascular disease (18% vs 14%), New York Heart Association class III/IV (55% vs 49%), prior myocardial infarction (22% vs 17%), and plasma creatinine 1.5 mg/dL or greater (21% vs
Comment
With advancement in medical sciences and better management of cardiovascular disease and comorbidities, the projected life expectancy of elderly patients continues to rise [20]. This has generated an expanding population of geriatric patients who present with “surgical cardiac disease” requiring operative intervention. Technical advancements in cardiac surgery, better myocardial protection strategies, and improved perioperative care have enabled safe accomplishment of valve replacements in
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The opinions expressed are those of the authors and not necessarily those of the Department of Veterans Affairs or the United States Government.